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<br />l 1/14/2008 18:21 <br /> <br />LION INSURANCE COMPANY <br /> <br />LYONS I NSURANCE COMPANy.... Air Nati ona I, LLC <br /> <br />1/1 <br /> <br /> Dale <br />. ACORD TM CERTIFICATE OF LIABILITY INSURANCE 1/14/08 <br />Producer: Lion Insurance Company This Certificate Is Issued as a matter of Information only and confers no rights <br /> 2739 u.s. Highway 19 N. upon the Certificate Holder. This Certificate does not amend, extend or alter <br /> Holiday, FL 34691 the coverage afforded by the policies below. <br /> Phone: 727-938-5562 Fax: 727-937-2138 <br /> Insurers Affording Coverage NAIC# <br />Insured: South East Personnel Leasing, Inc. Insurer A: Lion Insurance Company 11075 <br /> 2739 U.S. Highway 19 N. Insurer B: <br /> Holiday, FL 34691 Insurer C: <br /> Phone (727)938-5562 Insurer 0 <br /> Insurer E: <br />Coverages <br />The policIes of Insurance listed below have been Issued to the Insured named above for the policy penod indicated Notwithstanding any requirement, term or condition of eny cortrael or olher document WIth <br />respect to which thiS certIficate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms. e)a;:lisICfls. an::l condtions of such policies. Aggregate limits <br />shown may have been reduced by paid claims <br />INSR ADDL Type of Insurance Policy Number Policy Effective Policy Expiration Dale Limits <br />LTR INSRD Date <br /> (MMIDDIYY) (MM/DDIYY) <br /> ~NERAL LIABILITY Each Occurrence $ <br /> Commercial General Liability Damage to rented premises (EA <br /> : tJ Claims Made 0 Occur occurrence) ~ <br /> - Med Exp <br /> lo- Personal Adv Injury <br /> beneral aggregate limit applies per: <br /> t:l Policy o PrOject 0 General Aggregate $ <br /> LOC <br /> Products - Comp/Op Agg $ <br /> AUTOMOBILE LIABILITY Combined Single limit <br /> I- (EA ACCident) <br /> My Auto <br /> - Bodily Injury <br /> All <::Mned Autos <br /> "- (Per Person) <br /> Scheduled Autos <br /> "- Hired Autos Bodily Injury <br /> "- Non-Owned Autos (Per Accident) $ <br /> - Property Damage <br /> (Per Accident) ~ <br /> GARAGE LIABILITY Auto Only - Ea ACCident <br /> ~ My Auto Other Than EA Acc $ <br /> Autos Only AGG <br /> EXCESs/UMBRELLA LIABILITY Each Occurrence <br /> I- o Claims Made <br /> Occur Aggregate <br /> I- Deductible <br /> I- Retention <br /> I- <br />A Workers Compensation and X I WC Statu- I IOTH- <br /> WC 71949 0110112008 0110112009 tory L.mots ER <br /> Employers' Liability <br /> Arry proprietor/partner/executive officer/member E.L. Each Accident $1000000 <br /> excluded? EL Disease - Ea Employee $1000000 <br /> IIYes, describe under special provisions below. <br /> E.L. Disease - Policy Limots $1000000 <br /> Other 0665409 <br /> Air National, LLC COVERAGE APPLIES ONLY TO THOSE EMPLOYEES LEASED, NOT TO SUBCONTRACTORS. <br />Oescnptions of Operations/locationsNehicles/Exdusions added by Endorsement/Special Provisions: ADD ON DATE: 8/14/06 <br />COVERAGE APPLIES ONLY IN THE STATE OF FLORIDA TO THOSE EMPLOYEES LEASED TO BUT NOT SUBCONTRACTORS OF Air National, LLC' FAA: 813-514- <br />6458 & 813-7BO-0021IlSSUE 11-21-07 (SO) I REISSUE 01-14-08 (JOY) <br /> Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 <br />CERTIFICATE HOLDER CANCELLATION <br /> CITY OF ZEPHYRHILLS Should any of the above descnbed pobcles be cancelled before the expiration date thereof, the IssUIng <br /> Insurer wiU endeavor to mail 30 days wntten notice to the certificate holder named to the left, but failure to do <br /> BUILDING DEPARTMENT so shall Impose no obligation or ~abihty of any kind upon the Insurer, its agents or representatives <br /> 5335 BTH ST ~/-- <br /> ZEPHYRHILLS FL 33542 <br /> , <br /> <br />ACORD 2_, (1001/08) <br /> <br />ACORD CORPORATION 1988 <br />